Project Summary: This is the third and final submission of a Competing Renewal application for a K24 Midcareer Investigator Award in Patient-Oriented Research. This award will provide essential support for continued mentoring of beginning investigators and will greatly enhance my patient-oriented research. My current K24 award, which ends in 8/06, has provided critical support for my mentoring and has enabled me to develop new research skills. Consistent with the purpose of the K24, during my current award, I have written 85 publications (81 published or in press, and 4 submitted), many of which were co-authored by mentees. I have also obtained additional federal funding, provided research mentoring to 35 mentees, and participated in many additional national and local mentoring and leadership activities. I am one of the very few researchers of body dysmorphic disorder (BDD), an unusually severe, relatively common, and understudied disorder that is associated with markedly high rates of suicidal ideation, suicide attempts, and completed suicide. My primary career goals are to 1) continue patient- oriented research on BDD (in particular, its treatment), and 2) continue to recruit and mentor beginning researchers in patient-oriented research. My research plan includes current federally funded intervention studies for BDD. New research during the award period will focus primarily on developing and testing innovative new treatments. These studies will include an efficacy study comparing pharmacotherapy and CBT, and development of a combined treatment for more highly suicidal patients. Several studies will include translational components. My mentoring plan will focus primarily on interventions research as well as BDD specifically. I have developed expertise in developing and testing both pharmacologic and psychosocial interventions, which is relatively uncommon among interventionists and which enhances my mentoring. I will continue to mentor individual mentees and participate in national and local mentoring activities. My mentoring plan also includes submitting a T32 research training grant application on interventions and translational (basic-clinical) research on OCD and BDD. This area has a very limited pipeline of beginning investigators. Renewal of my K24 award will provide essential support for mentoring and enable me to sustain my fruitful program of research. Relevance to Public Health: BDD, although underrecognized, is relatively common. It is associated with greater suicidality and poorer functioning and quality of life than most other serious mental illnesses. It is critically important to continue BDD research and, through mentoring, develop a cadre of researchers to continue this work. My mentoring on interventions research more broadly will help meet a pressing need for future researchers in this critically important area. [unreadable] [unreadable] [unreadable]